2009
DOI: 10.1002/lt.21581
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Subnormothermic machine perfusion protects steatotic livers against preservation injury: A potential for donor pool increase?

Abstract: We tested whether rat liver preservation performed by machine perfusion (MP) at 20°C can enhance the functional integrity of steatotic livers versus simple cold storage. We also compared MP at 20°C with hypothermic MP at 8°C, and 4°C. Obese and lean male Zucker rats were used as liver donors. MP was performed for 6 hours with a glucose and N-acetylcysteine-supplemented Krebs-Henseleit solution. Both MP and cold storage preserved livers were reperfused with Krebs-Henseleit solution (2 hours at 37°C). MP at 4°C … Show more

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Cited by 97 publications
(99 citation statements)
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“…Another approach is the use of subnormothermic machine perfusion (SNMP) with perfusate temperatures at 208C-308C, which is somewhat simpler to perform than normothermic extracorporeal liver perfusion (NELP) from a technical standpoint. (16,17) Importantly, by maintaining 25% of metabolic activity, SNMP allows functional assessment of the liver. (18) Although SNMP has had promising outcomes with DCD liver transplants in animal models, (19) with a considerable reduction in the metabolism rate of the hepatocytes, it may preclude the use of preconditioning modalities such as defatting.…”
mentioning
confidence: 99%
“…Another approach is the use of subnormothermic machine perfusion (SNMP) with perfusate temperatures at 208C-308C, which is somewhat simpler to perform than normothermic extracorporeal liver perfusion (NELP) from a technical standpoint. (16,17) Importantly, by maintaining 25% of metabolic activity, SNMP allows functional assessment of the liver. (18) Although SNMP has had promising outcomes with DCD liver transplants in animal models, (19) with a considerable reduction in the metabolism rate of the hepatocytes, it may preclude the use of preconditioning modalities such as defatting.…”
mentioning
confidence: 99%
“…61 On the other hand, the composition of hepatic lipids and particularly thromboxane A 2 levels are considered the principal modulators of I/R injury in the steatotic livers, while the size and morphology of lipid droplets are insignificant. 70 Other potential mechanisms that have been proposed include Kupffer cell dysfunction, 71 more lipid peroxidation, 72,73 more exuberant pro-inflammatory responses, including increased release of pro-inflammatory mediators such as TNF-α, 74 and impaired leukocyte adhesion. 75 Therefore, it is likely that the increased vulnerability of the steatotic livers to more I/R injury are multifactorial, and further experimental studies are required to elucidate the underlying mechanisms.…”
Section: Impact Of Steatosis On Ltmentioning
confidence: 99%
“…In line with I/R research (25,29), hypothermia (4°C) might not confer additional protection when compared with subnormothermic temperatures (20° to 30°C), whereas subnormothermic temperatures could circumvent the drawbacks associated with deep hypothermia (101). In a rat model of liver transplantation, SNMP at 20°C improved the hepatocellular energy status and reduced ROS formation during reperfusion compared to SCS (101).…”
Section: Disclosurementioning
confidence: 99%